Gunmen break into your home and threaten your family. You hand over whatever they ask for, whatever it takes to head off disaster. An immediate, serious threat wonderfully concentrates the mind. The issues are clear, your response immediate and the results soon apparent. In contrast, complex threats are confusing: What is the problem, what’s at risk, how long do we have to figure this out? Can we afford to fix it? Once we realize we’re dealing with something very dangerous we can’t delay – we must act to save ourselves.

The results of humanity’s war on the environment have taken decades to emerge while irreversible damage has been done. Within the past eight months a series of authoritative reports have spelled out how our societies are destroying the earth systems we depend upon for survival. The latest is the Global Assessment Report on Biodiversity and Ecosystem Services, which confirms that a mass extinction of plant and animal species is well under way. Habitat, fresh water, the health of the oceans are all in decline. Actionable information is available; our response inadequate. The question is why?

Clearly many still refuse to believe the science and the evidence of change right in front of their eyes. Perhaps that explains why last month GOP members of the Minnesota House of Representatives voted against a declaration acknowledging that human activities have caused climate change. And why clean energy policy was thrown under the train by GOP Senate leadership. Maybe no one noticed that changing climate conditions have left many Midwest farms either underwater or trying to dry out.

Some apparently believe their wealth insulates them from disaster. They are sadly mistaken. Others simply miscalculate. EPA Administrator Andrew Wheeler says not to worry; real consequences of climate change are 50-75 years away. But 50-75 years is within the lifespan of today’s toddlers — and, for most of us, our children are a top priority. Maybe Wheeler has trouble with the arithmetic. Or perhaps he figures policymakers have 50 to 75 years to begin fixing things; it’s a total misunderstanding of the immense task at hand.

Another reason for delaying action hinges on cost. Can we afford clean energy? How will the economy handle reductions in how much we consume and throw out? The abandonment of fossil fuel resources and power plants? What about jobs and investments? Trillions of dollars? How can we take that on? Good questions, but in a way the answer is simple: The costs are whatever it takes to salvage a world we can survive on.

A more involved answer involves how we determine the real costs of what we purchase.

We’ve been told that our planetary resources (fossil fuels, clean air and water, etc.) are cheap or free and unlimited. In our defense it took time and research to reveal the hidden costs: crop failures; toxic oceans; billions in storm and wildfire damage; impaired health; millions of climate refugees; oh, and coastal real estate – potentially trillions in losses. Costs we didn’t figure on and would rather forget about. Unfortunately, it’s no longer a matter of what we are willing to pay. It is the matter of paying whatever it takes to save ourselves.

Our use of natural resources represents unpaid purchases. We took possession of the coal, the oil, the forests, the land. We used and degraded them; they can’t be returned, and now the bill is due. You break it, you buy it. Payment is not optional; we must pay whatever it takes or risk losing everything.

We have accepted and assumed that year over year there will be more vehicles, appliances, war machines, devices, hospitals, homes, buildings, data centers, etc. And we are stunned when the consequences of advanced environmental destruction become too obvious and severe to ignore. We are not psychologically or socially prepared for this. Solutions, such as they are, will be expensive and will require a dramatic reimagining of our futures. This bill must be paid. Interest is adding up quickly. The price is whatever it takes.

Bruce D. Snyder, M.D., FAAN, is a member of Health Professionals for a Healthy Climate, an organization of Minnesota health care professionals concerned with the health impacts of climate change.